How Do You Treat Migraines?

sherilynnJuly 27, 2008

To All of you that are Migraneurs, you have my compassion. As most of you that suffer episodic headaches that are incredibly debilitating, you know how important it is to have a solid treatment plan in place. I did have such a plan until this past March.

On March 9th, I hurriedly stuck my head under my goose neck faucet in my bathroom to wet my short hair so I could do a quick blow dry to run my son to school. In my hurry, I raised up my head on the 'beak' of my faucet and almost brought myself to my knees. No blood came rushing, but a goose egg started forming very quickly on the crown of my head. A headache followed.

The next morning, would you believe, the very same thing happened, but this time when I raised up and hit my head, I almost passed out, first seeing white stars and an aura, then seeing black star spots...but never passed out. I became immediately nauseous and began a day long vomiting session along with a violent headache. I did end up in the ER, with nothing helping my pain, but they did eventually help get the vomiting to stop.

Four months later, I still have this goose egg on my head that is hyper-tender beyond imagination and I stay in a chronic migraine headache state. All smells, taste, hearing, and seeing light is amplified. I also have these new spots on my scalp that are the nerves from the goose egg area that have migrated to other areas of my head; so this is spreading. No joke...and it's just as tender, as though it was struck in those areas, too. I do try to go into a full flown migraine about 1~2 times a week that I can head off with Imitrex shots or pills. But life is really tender. Sounds are amplified. Wind in my hair makes me sick. Combing my hair or the shower on my scalp makes me want to vomit. Going on the boat with the wind blowing is a 'no go'. I just can't do it.

Bottom-line: I've had a CAT scan and nothing is 'there'. I've seen a neurologist and am starting a new prophylactic treatment (topomax) as well as he wants me to have an occipital nerve block. I am in such a chronic headache state and cannot find any relief. Honestly, I don't know what to do. If I take anything like a Goody powder or Excedrin, it stimulates the nerves in my 'goose egg' area and causes rebound headaches. So, I'm in total withdrawal for over the counter medication pain meds now.

Have any of you had a brain nerve block before? Or any other type of treatment for migraines that you could share? I've had an epidural before and know it's temporary. I'm just nervous about this procedure and know no one that's had it.

Thank you.

Sheri Lynn

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Sheri............oh my goodness, I am so sorry! I have no idea what you could do next, but having dealt with a lot of migraines (of the mild to medium grade variety) this year, I can't even think about your pain without feeling nauseous myself.

I hope your neurologist can help you get relief. I hope you will swear off the casual wetting of your hair.......Forever. And I hope that someone else here can give you some kind of info that can bring an end to your pain.

Sincerely, Red

    Bookmark   July 28, 2008 at 2:22AM
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My temporary doctor is wonderful. Let me quote new Dr. Wonderful, "I'm your temp doc since your regular FP doc is in that God-forsaken hell hole called Guantanamo Bay serving our country for our common good. I'll try to do the same for you." :) And he is.

Dr. W called me yesterday and told me he had been on call all weekend (we're military retirees) and just got my message. He told me that he would do the occipital nerve block if it was only one area but since it was in several areas, then he would leave it to the pros. Comforting thought there, isn't it. I explained that I fully understood that the caffeine in the OTC meds I was taking also caused the rebound headaches and kept the nerves 'frayed and agitated' in my trauma area in my head, so I 'got' why I needed to be off those meds. However, I can't take this pain. He couldn't believe that the neuro left me high and dry and didn't give me anything. He also couldn't believe that the neuro didn't do the nerve block.

So, Dr. Wonderful is putting me in some kind of cocktail prescription today of three meds that I'll take for about five days and he swears that this will alleviate the pain until the referral to the pain clinic comes through. He also said, "If these don't work, we have 1,000 options out there!" I love a doctor that gives you hope. I hate how everything has to be approved by someone else before I can go see another doctor or clinic.

When I get the prescriptions, I'll post what they are and how they affect me.

    Bookmark   July 28, 2008 at 9:25AM
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Sheri Lynn - I'm so sorry you're going through this. I just don't understand how you could be in pain for so long and how the CAT scan could show nothing. (Would it show if you actually hit hard enough to fracture your skull?)

When I get stressed, I seem to get bursitis in my hip. The pain obviously isn't nearly on the same level as yours, but it can be hard to get rid of. I favor the hip, it gets worse, so I favor the hip more... One year, in NYC, I tried acupuncture for it. I could only do one session. The acupuncture didn't cure me, but it relieved the pain enough that I was able to stop favoring the hip. It let the ibuprofen and cold/hot packs do their work.

Bottom line: It doesn't hurt to try. You can barely feel the needles (they don't hurt). You would want to get recommendations and check training, and I'd send someone in first to make sure there aren't any strong smells. There weren't any at the place I went - very clinical - but I well understand how smells can trigger problems.

I hope you feel better,

    Bookmark   July 28, 2008 at 12:04PM
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I have a wonderful internist and neuro (finally after feeling like part of a herd of cattle from others). My internist gave me an article on migraines and suggested reading current info on the ratios of strokes for those of us with migraines. Both are believers this is signficant.

Am on the migrainer's diet which is a low tyramine diet. Also a cocktail (love this word) of over the counter meds and prescription. I hate the diet as it took away all of my loved foods. It is working because the migrains have seriously dropped off and have one when I mess up on the diet.

There is a research trial going on in my town relating to migrains and a little seen/known defect of the heart. They are performing surgeries on this. But I really don't know much about it and not a fan of invasive surgery trials.

Most of the neuros here are using Botox which didn't work for me.

Considering research trials is a positive in my book. There is a great deal going on and can be a lifesaver paying for medical care. Also, research doctors go beyond in caring for participants, giving tons of testing which is usually not offered to us through normal channels.

This info may not be for everyone and I'm not the all knowing by any stretch. But interesting reading about so much being done, that they are listening to us and understand the life we live.

Here is a link that might be useful: low tyramine diet

    Bookmark   July 28, 2008 at 12:39PM
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That doesn't sound like a migraine, though it may feel like one. I'd be concerned first about the goose egg on your head, it's been there far too long. Why hasn't it been drained. Is it a sterile abscess, or an infection? Both could lead to problems. Once that's gone, maybe your headache will start to disappear. I suspect the "aura" you saw was a coincidence, not the beginnings of a migraine.

Calling this headache a migraine just distracts from finding out what's really wrong.

There's just no excuse for someone having a headache for four months, this should have been taken more seriously. Are you near a city that has a headache clinic like this one. (I don't live in Texas, but I've used their info for my daughter's migraines.) These clinics take headaches very seriously. A four month headache is a symptom of something that needs to be investigated.

(I know about migraines, I've had them most of my life, and 11 years ago I had two of them in a few days that knocked me to my knees, no aura, just blinding pain. I'm now on Cardizem and it works for me. I still get an aura, but no headaches, though I do have atypical migraines. I've figured out most of the triggers, and they aren't a real problem any more. We are now trying to solve the problems of my oldest daughter and her all to frequent migraines. She just started on the low tyramine diet - we'll see how it works.)

Good luck.

    Bookmark   July 28, 2008 at 7:52PM
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I think MomJ has a really good point. Made an assumption on my part that you knew this was a migraine. But as she pointed out, the accident could definitely be a direction you should persue for causing these headaches.

    Bookmark   July 30, 2008 at 9:55AM
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Had an MRI?
Spinal tap?
Ruled out pseudotumor cerebri?
Complex regional pain syndrome?
Maybe the goose egg is just coincidental with something else?
Wishing you all the best in solving this and getting relief.

    Bookmark   July 30, 2008 at 8:55PM
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Absolutely you should have an MRI. Though it's easy for me as an armchair doctor to say that I can't believe they haven't worked harder to find out what is causing your pain and why you still have a lump on your head, surely there is more to be done. How do you function daily???? I'm so sorry you are having to deal with this.

emagineer-- my husband had an echocardiogram to determine whether he had the heart defect that I believe you are talking about. He has had two suspected tia's. They told us nothing showed up, so I'm guessing that this is the test that determines whether one exists.

    Bookmark   July 31, 2008 at 12:08AM
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Below is a link to the study. It is from the LDS hospital, but same as one being done here in CO. I do hope your husband is well. They are doing so much now for resolving little known health issues. And it sounds like you have a doctor willing to go beyond in resolving such.

Here is a link that might be useful: Heart study

    Bookmark   August 1, 2008 at 12:09PM
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Read the article...I have PFO but no migraines! I guess I'm lucky. (Trivial blood leakage b/w chambers in my case.)

My SIL does have severe migraines, I'm passing all this to her. is the "cocktail" working? Has your Temp Doctor suggested the MRI or other procedures besides pain killers and the nerve block? It sounds more like treating the symptoms rather than the, I'm not a doctor, but I've had to be an advocate on my and my children's behalf in the past when I thought the doctor's weren't trying hard enough or looking far enough. Can you get a referral to a different neurologist?

We had the most problems when we were in an HMO, if it isn't something common (like on the "Top 25" list of common problems), I find that HMOs need a lot of pressure to get them to do anything. That's why I'm no longer with an HMO!

Good luck, keep looking/fighting, and keep us posted!

    Bookmark   August 2, 2008 at 3:39AM
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Hi, I've been waiting to post for a few days so I could give a fair assessment of exactly 'how I am responding' to treatment. I can now say, with absolute clarity and conviction so that no one is confused here, that I do have episodic migraines 2~4 times a month. I can usually head those off at the pass with Imitrex shots or pills; I switch up depending on how soon I can get to the headache. A pill if I'm not nauseous or vomiting. A shot if I am over the edge.

THAT being said, I want to tell you where I am with treatment right now.

For migraines:

1) The neurologist told me that the 50 mg of Imitrex tablets that I was using was probably not strong enough and told me to use 100 mg tablets or double the 50 mgs. I couldn't believe it, but I've already had an opportunity to use this new dosage and I had less side effects from taking this amount -Vs- taking the lower amount! No kidding.

(2) He also put me on Topamax as a prophylactic. It's too early for me to tell how this will work. So far, no side effects that I can tell. It's quite involved to start taking this medication as they increase the dosage, so it takes a series of increasing dosages over three weeks to get to a target amount to start. I'm still in those parameters.

For this current chronic headache: Having been in a constant headache state such that I have been since March, I could not eve differentiate with clarity the pain levels. I felt so inadequate and sickened trying to explain the pain levels without sounding so ridiculous, exaggerating, or needy... to a doctor, when you can see that there are other people with more serious medical needs than mine in the waiting room. Anyway, when they ask, "What is your current pain level?" I answer something RIDICULOUSLY conservative like, "6 or 7," out of a 10 point scale, with 10 being the worse. NOW that I have had some success with this pain, I can tell you I was like a damn 30 and I am NOW a 6 or 7 on the pain scale as I type right now.~~ !!!!

So, how have I improved this much? Well, I had the occipital nerve block last week. I believe you'd call mine the 'greater nerve block' -Vs- the alternative 'lesser' nerve block. If you Goggle it, you will see what I mean. Before I continue, I have to tell you, this is a treatment that I believe every single doctor and NP in America should know how to do. It is that amazing. But please, pay attention closely to my description of my experience. I say this because with some of my key words you **might** find some phrases or explanations in medical journals online, but it's not easily out there to tell you from a lay-person's perspective, how this feels and how it has affected me.

Also, without going into boring details, I have to say that here in Jacksonville, FL, I could only find ONE neurologist to do this occipital nerve block and he was is associated with Shands Hospital. Even the neurologist that referred me to him did not do them. Now I know he's not the only game in town, but doctors just don't do these things like I think they should! SO MANY people could find relief, I am sure.

OK, here's what happened. The doctor comes in after getting approved (by insurance) for the procedure (2 day, 2 hr. wait), and explains that he is going to put in 8~10 shots in my neck and upper shoulders. He WARNED ME that if he did "not hear certain sounds", that he would "stop the procedure" because "this is like a truth serum; I can tell if you are really in pain or not... nerves speak and they can tell me exactly what kind of pain that you are in."

The needles were not inserted into my brain or spinal column. I sat in a chair, leaning my head on a pillow on a table in front of me. The doctor felt for the base of my skull and within 6 ~ 8 minutes had injected all shots. Two or three down the left side of my neck, then two or three down the right, and four places across the top of my back shoulders, with two being to the left of my spine and two on the right, rather evenly spaced.

What was AMAZING was when he put in the first needle on my right side of the neck upper at the base of my skull. As he inserted the needle, it sounded like it was going into Styrofoam. The sounds that came out of that nerve as the needle and medicine went in would have made you think I was possessed and demons were crunching their way out of my body. It hurt like a blank-blank because he rubbed each shot sight's medication in with his thumb after shooting in the meds. All I could say the entire time is, "OMG. Lord Jesus, come," over and over. My nerves made audible sounds like chewing Cap'N Crunch cereal, and lesser sounds like Rice Crispy's in the beginning. Let me clarify this for you: the nerves made a **CRUNCHING SOUND** AND **SNAP, CRACKLE, POPPING SOUNDS**. The doctor said that these were "some of the worst/best sounds he has ever heard come out of a patient...up there in the top three." He also assured me I would feel 100% better when I left; clarifying that I would not feel 100%, just 100% better.

Boy, do I know what he means. The occipital nerve block was quick easy and AMAZING. It was painful, but after what I've gone through the past few months, it was tolerable and worth it. I'm going to have another one in 11 weeks. He also said that some Migraneurs find relief from this, too, even though I'm doing this for my head injury swelling and trying to stop the pain cycle.

Also, I left the office after about 10~15 minutes and of having the ONB and have had no real side effects that I can tell other than soreness and a slight bruising in one area.

What did it do for me? My chronic headache throbbing stopped within five minutes of the ONB (Occipital Nerve Block). Now, my head still feels like I've been battered and hit hard, very, very tender, but at least the headache is gone. I had a slight thumbprint size bruising in one area on my neck from the shots. Other than that, all has been good. Two days after I had this done, I awoke with a migraine, not sure what kind of a headache it was, I took the Imitrex 100 mg dose and in 30~40 mins. it was gone.

So, I talked to my FP doctor who followed up after the block. I explained the still extreme tenderness when I showered and walked and wind in my hair, but the throbbing WAS GONE. But now, I just felt 'damaged'. I also explained I was still had the issue of not being able to sleep and was still nauseated. He understood. He gave me a 'cocktail prescription' of Benadryl, Reglan, and 20 mg. of Prednizone to take three times a day for swelling and nausea. I have never, ever been able to take Benadryl because it will knock me for a loop. But, honestly, I've taken all five days and I actually slept every night except for last night, which I was up about five times. The meds have not made me sleep during the day at all either.

So, I'm waiting right now for another Prednizone prescription for maybe another 10 days. We'll see.

Thank you all so much for your suggestions and sharing your sites. I am going to keep all info and I have read some of the sites already. I pretty much follow the low tyramine diet as is and miss chicken livers.

Here is a link that might be useful: Occipital Nerve Block

    Bookmark   August 4, 2008 at 9:37AM
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Update: I'm on a 12 day 'come off Prednizone slowly pack' to hopefully give this head a chance to heal. It is getting better every single day, but still very tender.

    Bookmark   August 5, 2008 at 9:29PM
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So glad you're starting to feel better.

    Bookmark   August 6, 2008 at 8:52AM
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Hurray! I'll continue to watch for your postings. Wishing you many painfree days!

    Bookmark   August 18, 2008 at 4:46AM
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Glad to hear you are doing better.

    Bookmark   August 18, 2008 at 9:45PM
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I was perusing the kitchen forum and came across this. This may be a simple hormonal problem. Find a bioidentical hormone specialist. They treat migraines. One in NYC is Dr. Erica Schwartz. In CT, there is Robban Sica or Dr. Sobo.

    Bookmark   February 7, 2010 at 9:00PM
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Just thought I'd mention that there's a new treatment for migraines: 2.5mg Bystolic each night.

    Bookmark   April 5, 2010 at 12:50AM
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